对成本共享变化的异质需求反应的政策影响:来自奥地利的患者层面证据
Michael Berger1, Eva Six2, Thomas Czypionka3
1Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria; Institute for Advanced Studies, Josefstädterstraße 39, 1080, Vienna, Austria.
Social science & medicine (1982)
|December 15, 2023
概括
医疗保健成本共享对患者需求的影响因服务的紧迫性和价格而异. 共同保险的减少特别影响可推迟和昂贵的服务,显示患者的反应各不相同.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 行为经济学是一种行为经济学.
背景情况:
- 成本共享是影响收入和患者行为的关键医疗保健政策工具.
- 以前的研究经常使用宏观视角,忽略了对跨多种服务成本共享的异质需求反应.
研究的目的:
- 分析患者对降低共同保险费率的需求反应.
- 调查服务特征 (紧急性,价格) 如何改变这些反应.
- 为决策者提供细微的成本共享影响的信息.
主要方法:
- 根据紧急情况和价格对11项医疗保健服务进行分类.
- 两阶段研究设计:匹配和差异差异估计.
- 对奥地利疾病基金的共同保险削减的预期需求反应的分析.
主要成果:
- 观察到医疗保健服务利用率的整体增加为0.8%.
- 显著的利用率增长是由可推迟 (+1%) 和昂贵的服务 (+1.4%) 推动的,特别是当这两个因素都被应用时 (+1.6%).
- 对于廉价或紧急服务,没有发现明确的需求反应,这突显了需求异质性.
结论:
- 即使是微小的患者成本变化也可以引起有形的需求反应.
- 医疗保健服务需求异质,受到紧迫性和成本的影响.
- 决策者在设计成本共享战略时必须考虑这种异质性.
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